Medicare hospice is a voluntary election that the resident would have to make an 
informed choice about.  This is not something that the facility "puts them on"... If 
you are contracting with a hospice provider, there is a possibility that the attending 
could refer to the hospice MD for an eval and the resident/family could make that 
decision as to what is best for them.  As for Part A, the coverage criteria do not 
change at the end of life, what are their skilled needs; you can use the alternative 
Medicare criteria but if the resident RUGS out at the lower 18 categories, you need to 
be able to articulate in very precise and frequent documentation why they are 
receiving skilled services. I have not run across anyone who has successfully done so 
but would be interested in anyone who has a success to report.   

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Wiedemann, Betty R
Sent: Monday, April 12, 2004 2:43 PM
To: List Server (E-mail)
Subject: FW: medicare A vs hospice



second try. or has everyone left for NJ?
-----Original Message-----
From: Wiedemann, Betty R 
Sent: Monday, April 12, 2004 12:39 PM
To: Wiedemann, Betty R
Subject: FW: medicare A vs hospice




-----Original Message-----
From: Wiedemann, Betty R [mailto:[EMAIL PROTECTED] 
Sent: Monday, April 12, 2004 10:10 AM
To: List Server (E-mail)
Subject: medicare A vs hospice


With in the last month we have had 3 Rt return from  acute care who have
crashed. The MD feels there is no way they can survive. 
My question is.. if staff are providing skilled assesments for Pain
management, DU's or emotional comfort for someone who will die soon, are we
still able to keep on Medicare
A. 
I see that "services that could qualify as skilled nursing (1) overall
mangement of plan of care" would qualify. As well as (2) observation and
assessment of the Rt changing condition"  Am I on the right track?

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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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